Association between salivary inflammatory mediators and oral mucositis in patients with cancer undergoing chemotherapy

Support Care Cancer. 2024 Sep 2;32(9):625. doi: 10.1007/s00520-024-08836-1.

Abstract

Purpose: Oral mucositis is a severe adverse event in patients undergoing chemotherapy and radiotherapy that may lead to the termination of cancer treatment. This study aimed to elucidate the relationship between salivary inflammatory mediators and oral mucositis in patients undergoing chemotherapy.

Methods: This prospective cohort study included 167 patients who underwent chemotherapy at our institution between June 2020 and November 2023. We evaluated the association between chemotherapy-induced oral mucositis and salivary inflammatory mediators using multiple comparison tests and logistic regression analyses.

Results: Of the 167 patients, 67 (40.1%) had oral mucositis. Dunn's multiple comparison test revealed that interleukin-6 was significantly higher in oral mucositis of grades 2 and ≥ 3 (P < 0.01) and tumor necrosis factor (TNF)-α was significantly higher in oral mucositis of grades 3-4 (P < 0.01). Logistic regression analysis showed that the risk of oral mucositis was significantly higher for tumor necrosis factor (TNF)-α > 4.4 pg/mL than for TNF-α ≤ 4.4 pg/mL (adjusted odds ratio, 2.4; 95% confidence interval, 1.1-5.3; P = 0.03).

Conclusion: Saliva is useful in evaluating inflammation in patients with chemotherapy-induced oral mucositis. Furthermore, TNF-α may be a predictive marker for the severity of oral mucositis in patients undergoing chemotherapy.

Keywords: Cancer; Chemotherapy; Inflammatory mediators; Oral mucositis; Saliva.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents* / adverse effects
  • Cohort Studies
  • Female
  • Humans
  • Inflammation Mediators* / metabolism
  • Interleukin-6 / analysis
  • Interleukin-6 / metabolism
  • Male
  • Middle Aged
  • Neoplasms* / drug therapy
  • Prospective Studies
  • Saliva*
  • Severity of Illness Index
  • Stomatitis* / chemically induced
  • Tumor Necrosis Factor-alpha* / metabolism

Substances

  • Tumor Necrosis Factor-alpha
  • Antineoplastic Agents
  • Inflammation Mediators
  • Interleukin-6